I think I sort of wrote about Lucy’s birth before, but I feel like I need to document the whole thing. I’m working up to writing about Lucy’s last few days, so I thought I’d start with something slightly less traumatic, although it was still pretty traumatic. If you don’t want to hear about things like blood and cervical insufficiency, now might be a good place to stop reading.
At 23 weeks, you’re not thinking about labor yet. Well, I’ll speak for myself. I was not ready to think about labor and delivery yet at 23 weeks. I had a halfway-point fetal survey ultrasound on Thursday, March 22. Everything looked great, and I was just excited to see my baby, and for David to be able to feel her kicking sometimes. That weekend we drove to Orange County for a friend’s baby shower, visiting the brother and sister in law, and some Ikea shopping. Side note: at the baby shower, there were six pregnant women. We took a picture, all lined up in order of our due dates. I was last in line, and never EVER imagined that I’d be the first to give birth in just a few days. Those other five have since given birth to five healthy babies, fortunately. Anyway, the whole weekend Lucy was just as active as can be, and I kept telling David that she was trying to come out, because she was punch punch punching straight down onto my cervix. After a fairly active weekend, we returned home with Lucy’s new changing table, the first piece of furniture we’d bought for her nursery. Monday was pretty uneventful except for continued cervix punches. Then, around 8:00 Monday night, I started noticing these pains that would come in waves. It didn’t feel like contractions (not that I was expecting contractions), but just really intense lower back pain that would come and go. I complained about it a little, but went to bed.
I couldn’t really sleep, and the pains just kept getting worse. When I finally did fall asleep, they’d just wake me up again, so I started seeing how far apart they were. Ten minutes, every time. In hindsight, experiencing pains like that at 10 minute intervals should have had me to the doctor a lot sooner. I don’t know if I was in denial, but I just kept thinking “you’re being dumb, it’s probably nothing, just go back to sleep.” In the morning David went to work and I tried to sleep. At about 8:00 am I got up to go to the bathroom, threw up, got a nosebleed, and had slightly bloody discharge. Worried, I called a nurse at my doctor’s office (two hours away, did I mention?) I described my symptoms, she made me an appointment for 3:00 pm, but told me it didn’t sound serious. (It turned out she cancelled the appointment because she didn’t think I was going to come.) I had David come home to take me, and we got to Bakersfield a little early so went shopping for work clothes for David. All the while, I was still having these awful pains every 8-10 minutes.
We got to the doctor’s office, found my appointment had been cancelled, then saw the on-call doctor instead. We got in quickly, he took one look, and gave us the bad news. He said I was dilated 3 cm with bulging membranes that he could see, and that I had an incompetent cervix. That just means that my cervix was too weak to bear the increasing weight of the baby, which caused it to thin and dilate, which in turn started my premature labor. His plan was to send me to labor and delivery (just down the hall, fortunately) and try to stop my labor. If he could stop it, he would put in an emergency cerclage, which is where they basically just stitch your cervix closed. He couldn’t risk it unless my labor was stopped though. Then I was going to be on permanent bed rest in the hospital until it was time to have her. I started to get down from the table, kind of in shock but still not nearly as worried as I should have been, but he made me wait for a wheelchair. I remember thinking “come on, it’s just down the hall,” but I didn’t realize how precarious the situation was.
They got me to labor and delivery, checked me in, got me into a gown, got IVs started, and really, the rest is kind of a blur. Needless to say, they never got to try that emergency cerclage. First, they tilted the whole bed backwards, so that my head was down. It sounds so primitive, but I guess they want gravity on their side. They started me on magnesium sulfate to try to stop my contractions. Magnesium sulfate has the unpleasant effects of making you feel disoriented and as if you have a bad flu, with hot flashes, then shaking cold, nausea (as if I weren’t nauseated enough), etc. That wasn’t working, so they gave me a shot of something else in my arm, but I can’t remember what it was. I was lying on my side for a long time, and I could feel that something wasn’t right, but I didn’t want to hear any more bad news. So when the nurse moved me and David said “uh oh,” I already knew what he was talking about, and the nurse saw that I was lying in a pool of blood. She cleaned me up and made me lay on my back, which was the most intensely uncomfortable thing I’ve ever had to do. I kept trying to turn slightly to one side, but every time I moved or had a contraction, I bled more. At some point I got a shot of steroids in my hip (to strengthen Lucy’s lungs), but it didn’t have time to work (it requires two doses over 48 hours). My time is all a blur, but my parents showed up during the night and sat in the hospital room with us. Finally my dad took David to get a bite to eat.
They hadn’t been gone very long when I started another contraction (they were coming about every 5 minutes now) and my water broke. I think that’s when I realized that none of this was going to work and I was going to have my baby soon. I was too out of it to really think about it too much, though. David and Dad were called back before they could eat. Not too long after that, I started to feel more pressure, so I told the nurse to call the OB and the neonatologist, neither of whom were in the hospital. After that, I remember just thinking “come on Jill, you can’t deliver the baby until the neonatologist is here.” The doctor showed up, took a quick look, and said we were going to push. David was on one side, my mom was on the other. Pushing was not much of an ordeal. It doesn’t take too much to deliver a one pound baby, although I wasn’t fully dilated and it still hurt. It only took 2 good pushes and she was out.
I never saw her then. David and my mom did, and they said she was limp and purple, and the doctor passed her off holding her by her behind. I guess I’m kind of glad I didn’t see that. All I knew then was that the doctor was hurting me, and I was so confused. I don’t know what was shock and what was the medications they’d been giving me, but it was all kind of terrifying. The doctor was kneading my stomach to get the placenta out, I was bleeding a lot and hurting a lot, and I didn’t know what was going on with the baby. I still didn’t know it was Lucy yet, because I didn’t know if it was a boy or a girl. I heard one of the NICU nurses say “he” and I said “It’s a boy?” I heard “Umm … no, it’s a girl.” I said “Her name is Lucy. Lucy Anne.” It felt really important that she have a name, and that they knew it.
It’s not really clear what happened after that. I recovered quickly, although I was in shock. Apparently I was cracking jokes and telling everyone to cheer up. We were waiting for the neonatologist to come tell us the news, but we’d already been told she only had a 20% chance of living through the night, so we were trying to prepare for the worst. Finally Dr. K came in about an hour later to update us. He told us they’d been able to resuscitate her, and that although they don’t usually go to extreme measures for babies weighing less than 500 grams (and Lucy weighed 480), Lucy responded well so they kept working. He said she was stable for the moment, but he still gave her only a 25% chance of survival. I think, then, that David took my mom to go see her in the NICU. It wasn’t until about 2 hours after her birth that I was able to go see her. I walked down to the NICU in my hospital gown, not sure what to expect. They showed me how to wash up to my elbows for 2 minutes, then dry, then use the special antibacterial lotion. Then, finally, I was able to meet Lucy.
I saw her and immediately burst into tears. I don’t know what I expected, but she barely looked human. I didn’t immediately connect her to the baby I’d felt kicking inside me just a few days ago. This is what we saw that first day:
A 23 week baby is just not ready to be out in the world. She was skin and bones, her head was a little deformed from delivery, and her skin was completely transparent. We left fingerprints on her if we touched her, and her skin was so fragile that we had to be careful not to tear it. The first few days were spent under the blue bili-light, which only added to her alien-ness. Still, after my initial shock and horror, I was so amazed by how perfect she was. Tiny perfect fingers and toes, squishy little ears, silly flat little nose. She was beautiful. Her eyes were still fused shut, and a few of her toes were stuck together, but those things all fixed themselves over time.
It took a little while for the shock to wear off and for me to get a little more used to our new situation, but I knew I loved that little girl more than anything, and that I would be lost forever without her. Unfortunately, that’s where I find myself now. But at least we had almost two months to get to know her, and she had time to grow into this sweet little girl.
Mama’s lost without you, Lucy Anne.